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The risk for development of multiple sclerosis has been associated with human leukocyte antigen-DRB1*1501-DQB1*0602 (HLA-DR15) genotype, low infant sibling exposure, and high Epstein-Barr nuclear antigen IgG levels. In a population-based case-control study (Tasmania, Australia), we found that the combined effect of HLA-DR15 positivity and low infant sibling exposure on multiple sclerosis (odds ratio, 7.88; 95% confidence interval, 3.43-18.11) was 3.9-fold greater than expected (test for interaction, p = 0.019) This interaction was observed irrespective of Epstein-Barr nuclear antigen IgG levels. This suggests that immune mechanisms involving HLA class II molecules are susceptible to modulation in early life. Ann Neurol 2009;66:261-265 ANN NEUROL 2010;67:259-263.

Original publication




Journal article


Ann Neurol

Publication Date





261 - 265


Adult, Case-Control Studies, Environment, Epstein-Barr Virus Nuclear Antigens, Female, Gene Frequency, Genetic Predisposition to Disease, Genotype, HLA-DR Antigens, HLA-DR Serological Subtypes, Humans, Infant, Male, Middle Aged, Multiple Sclerosis, Odds Ratio, Retrospective Studies, Risk Factors, Siblings